Weight loss: New endoscopic procedure could help reduce hunger hormone

Evan Walker
Evan Walker TheMediTary.Com |
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Researchers say a new endoscopic procedure may help people who are trying to lose weight through diet and exercise. wagnerokasaki/Getty Images
  • Researchers say a new procedure that burns stomach lining may help decrease production of hunger hormone ghrelin.
  • Ghrelin levels are typically higher in people with obesity and rise when they lose weight.
  • There’s currently no pharmacologic way of reducing ghrelin.

A new endoscopic procedure that involves a type of controlled burning of the stomach lining could reduce production of a hormone that triggers hunger.

That’s according to a new study that details the possible new weight-loss treatment on the horizon with what researchers called an innovative endoscopic procedure that ablates (burns) the stomach lining to reduce production of ghrelin, a hormone that triggers hunger.

Researchers say that change could decrease appetite and produce significant weight loss.

The findings haven’t been published yet in a peer-reviewed journal, but the results of the method’s first-in-human trial is scheduled to be presented at Digestive Disease Week 2024 later this month.

Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California who was not involved in the research, told Medical News Today it’s encouraging to see new procedures that may allow people not comfortable with current methods to still seek treatment for obesity.

“It’s minimally invasive and may attract people who are wary about surgery,” Ali said. “Endoscopic procedures have minimal down time compared to surgical intervention.”

However, Ali said, there are downsides as well.

“It’s comparable to other endoscopic procedures, such as gastroplication, already being done. These procedures are less effective in that there is typically less weight loss compared to surgery,” Ali said. “The endoscopic procedures are not as durable and there is significantly more weight gain compared to surgery down the road.”

“Finally, it is very difficult to get these types of procedures covered by insurance and results in a substantial cost to the patient,” he noted.

Dr. Steven Batash, a gastroenterologist at Batash Endoscopic Weight Loss in New York City who was not involved in the research, told Medical News Today that he has questions about the study.

“What was the exact number of patients that were studied with this ablation procedure and were there randomized controls done for comparison?” Batash asked. “Was the fundal ablation done alone or was it done in addition to the endoscopic sleeve gastroplasty, or was it done in addition to the endoscopic sleeve gastroplasty and GLP-1 agonists? If it was done in conjunction with the endoscopic sleeve gastroplasty and/or GLP-1 agonists, then the crucial question that needs to be addressed is what was responsible for the weight loss and decrease in appetite –the endoscopic sleeve gastroplasty or the fundal ablation?”

Batash said he also wonders if the hormone levels documented after the procedure at one month, three months, six months, or 12 months and was there a sustained decrease in the level of the hormone?

“It is important to note that with surgical bariatric procedures, the level of ghrelin is reduced because more than 50 percent of the stomach is resected. Yet these levels eventually reconstitute themselves within 9 to 12 months,” he explained.

Batash added that the ablation procedure works by burning or damaging the lining of the stomach and the stomach lining will reconstitute itself within a month, thereby starting again the enhanced production of the ghrelin hormone.

“It would therefore be expected that this effect of the decrease of ghrelin would be very short-lived,” Batash said. “What are the real risks of the ablation procedure? The fundus of the stomach is the thinnest part of the stomach. It has a rich vasculature. It abuts on many vital adjacent organs. Because of this reality, during a standard endoscopic sleeve gastroplasty, the fundus part of the stomach is avoided.

“What then are the real risks of fundal ablation of bleeding, perforation, and damage to adjacent organs?” he asked.

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